Vasomotor Rhinitis

Definition

Vasomotor Rhinitis is a common problem that involves long-standing nasal and sinus difficulty, unrelated to allergies.

Symptoms

Chronic nasal congestion, postnasal drip, nasal obstruction, sneezing, watery or mucous discharge from the nose, pain over or under the eyes. There is usually little seasonal variation and symptoms often occur daily. Frequently, one nostril will be blocked while the other side is clear. This unilateral blockage may alternate from nostril to nostril.

Aggravating Factors

Sudden changes in body temperature, such as going in or our of air conditioned environments, exposure to drafts or wind, high humidity, emotional upsets, and common nonspecific irritants (such as heavy exposure to dust and road dirt, cigarette smoke, aerosol sprays, shrubbery, etc.). Placing warm, toasty feet on a cold tile floor (on cold winter mornings, for example) can also trigger sneezing spasms.

Complications

Sinus infections and/or the overgrowth of nasal tissue (nasal polyps).

Causes

The nasal mucous membranes, blood vessels, and nasal glands are under finely tuned nervous control. Some nerves cause glandular secretion while others can turn off glands. Likewise, some nerves allow vascular congestion while others clear the nasal passages by vascular constriction. This complex nervous congestion is in response to the factors listed above. The nose becomes a hair trigger in response to low doses of the common environmental irritants we are all exposed to daily.

Treatment

• Avoidance of irritants listed above.
• Use of antihistamine and decongestant medicine as needed (sometimes required on a daily basis).
• Appropriate treatment of acute sinus infections.
• Nasal saline lavage (irrigation).
• Infrequent use of nose drops. Overuse of nose drops is discourage, as this often results in the worsening of all the symptoms. The same is true of most nasal sprays, but some newer ones, available by prescription, are effective if used according to the instructions.
• Large nasal polyps may require surgical removal.
• Allergy shots are of no help.

Outlook

Although troublesome at times, most patients do well through the use of medications and avoidance of the allergen(s). Vasomotor rhinitis often goes away on its own, but in the meantime, a certain amount of 'living with' the symptoms may be necessary. Our attitude is to treat the condition aggressively and reduce the symptoms as much as possible. We prefer to thing of our patients as coping with it rather than being (helpless victims) unable to retaliate at all!